Factors predicting patient perception of dysphonia caused by benign vocal fold lesions
Factors predicting patient perception of dysphonia caused by benign vocal fold lesions
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DOI：
10.1097/00005537-200410000-00004
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发表时间：
2004-10-01
期刊：
影响因子：
2.6
通讯作者：
He, T
中科院分区：
文献类型：
--
作者：
Behrman, A;Sulica, L;He, T
目标/假设。评估可能预测患者对发音障碍严重程度感知的因素，通过语音障碍指数（VHI）评分进行量化。我们假设：1）发声需求水平; 2）发声障碍严重程度的听觉-知觉评估; 3）发声功能（由发声声门闭合和粘膜波振动定义）是VIII评分的最重要预测因素。研究设计：回顾性分析100例良性声带病变患者。研究方法：VHI评分预测值的评估变量是声音需求水平、发声困难严重程度的听觉-知觉评估、粘膜波振动和发声声门闭合的完整性、病变类型、当前主诉的持续时间、吸烟、年龄和性别。在50名患者的子集中评估谐波噪声比。结果：常规发声的患者的VHI评分显著低于那些有更强烈（非唱歌/表演）发声需求的患者。戒烟患者的VIII评分高于目前吸烟或从未开始吸烟的患者。长期发声障碍的患者往往有较低的VIII评分比那些持续时间较短的声音投诉。发音障碍严重程度的听觉感知评估和声噪比是VIII评分的弱预测因子。年龄、性别、病变类型、发声声门闭合和粘膜波振动不是VHI评分的显著预测因素。结论：患者对发声障碍严重程度的感知与嗓音障碍评估过程中通常评估的许多因素无关。它似乎是一个重要的独立因素，在评估的影响，良性声带病变和治疗决策的关键。
Objectives/Hypothesis. To assess factors that may be predictive of patient perception of dysphonia severity, as quantified by the Voice Handicap Index (VHI) score. We hypothesize that 1) level of vocal demand; 2) auditory-perceptual evaluation of dysphonia severity; and 3) vocal function, as defined by phonatory glottal closure and mucosal wave vibration, are the most significant predictors of VIII score. Study Design: Retrospective review of 100 patients with benign vocal fold lesions. Methods: Variables assessed for predictive value to VHI score are level of vocal demands, auditory-perceptual evaluation of dysphonia severity, integrity of mucosal wave vibration and phonatory glottal closure, lesion type, duration of current complaint, smoking, age, and sex. Harmonic to noise ratio was assessed in a subset of 50 patients. Results: Patients with routine voice use had significantly lower VHI scores than those with more intensive (nonsinging/acting) vocal demands. Patients who quit smoking had greater VIII scores than those who currently smoke or never started. Patients with long-standing dysphonia tended to have lower VIII scores than those with shorter duration vocal complaints. Auditory-perceptual assessment of dysphonia severity and harmonic to noise ratio were weak predictors of VIII score. Age, sex, lesion type, phonatory glottal closure, and mucosal wave vibration were not significant predictors of VHI score. Conclusions: Patient perception of dysphonia severity is independent of many factors commonly assessed during the evaluation of voice disorders. It appears to be an important independent element in the assessment of the effect of a benign vocal fold lesion and critical to therapeutic decision-making.